Sept. 3, 2025

Truth, Noise, and Nonsense in Medicine

By Rita Colorito

Unqualified influencers, pseudoscience blogs, and posts with anecdotal cures: There's much dubious and downright dangerous health information online that can erode trust between patients and their physicians.

A 2024 report from The Lancet Digital Health underscores the danger, noting that overwhelming amounts of health information, increased social and political divisions, and poor health literacy has led to a sharp decline in public trust in physicians and hospitals from 72% in 2020 to 40% in 2024. Medical misinformation further exacerbates this decline in trust.

From problem to progress

While misinformation and disinformation have long existed, the proliferation of social media and the COVID-19 pandemic fueled the flames of fake health news. It's hard to quantify the universe of false information, but one study in Bulletin of the World Health Organization found the proportion of health-related misinformation on social media as high as nearly 29%.

Given an estimated 70% of adults use the internet to research health information, it's no wonder patients struggle to distinguish good from bad health information found online. This faulty "research" often makes its way to medical appointments, causing friction and frustration for patients and physicians alike.

There's hope here, though. Despite declining trust, research during the pandemic found people's personal physicians are still their number one most trusted source of information.

"One of the advantages that physicians have is the one-on-one context. You're already starting from a better place than a lot of public health communication campaigns that are just communicating into the void, out to millions of people," says Julia Minson, PhD, professor of public policy at the Harvard Kennedy School of Government. Her research focuses on the "psychology of disagreement" and scalable solutions for disagreement on hot-button topics like health decision-making.

Physicians, in turn, can feel pressure to convert these sometimes confrontational conversations into a collaborative encounter, says John Wynn, MD, a professor of clinical psychiatry at the University of Washington School of Medicine, a physician coach who often cares for physicians facing mental health challenges. “One of the reasons why physicians get burned out dealing with these patients is they feel like it’s their job to overcome this misinformation and convince this person to do the right thing.”

To keep the lines of communication open, it's better to view yourself as another source of information, says Dr. Wynn, instead of the "I'm-the-trained-expert" approach some physicians take. But how do you become the trusted source?

Steps to build or rebuild patient trust

Building or rebuilding trust when you don't see eye to eye can feel like a gargantuan task. Behavioral psychology, say Dr. Wynn and Dr. Minson, offers ways physicians and clinicians can engage patients with different beliefs to foster goodwill and good medicine.

Both nonverbal and verbal cues can affect patient trust and willingness to follow a care plan. Sitting down, making eye contact, and listening are the basic tenets of building patient trust, says Dr. Wynn.

"The best way to foster collaboration in any context-and by the way the best way to change people's minds-is to make sure they really feel like you're listening to them," says Dr. Wynn. But the listening part is where many physicians need help. He recommends these steps during patient interactions, but especially for potentially tense encounters:

• View all patient interaction as an effort at collaboration. "Say to yourself, whatever it is this patient's doing, no matter how confusing or frustrating it is, this is their effort to get through this. This is their way of joining the team," says Dr. Wynn.
• Give people time to speak. The average physician interrupts patients after 18 seconds. More surprising, the average patient will only talk for about 90 seconds if given the chance. While that can feel like a lifetime to physicians with crammed schedules, it's time worth taking. "There's social psychology research that goes back to at least the 1950s demonstrating that people are much more likely to listen to what you have to say, if, before you talk, they feel listened to," says Dr. Wynn. Time spent listening now saves time later in dealing with consequences of patients not following your clinical advice or pursuing dubious or dangerous alternative treatments.
• Ask questions about their research. Understand why the patient is investing trust in other resources. Questions to ask include: What's your sense of why this may help? How do you think this treatment might work? Why do you trust this source? Have you used it before and how did it help you?
• Speak so they'll understand. Avoid medical jargon and use metaphors to relay information. "One of the advantages of listening to the patient first is to understand their level of education and the type of language that's most likely to make sense to them," says Dr. Wynn.
• Praise their effort before offering your advice. Patients often complain that physicians sound dismissive or condescending of their online information. Instead acknowledge the work they did to learn about their health. Dr. Wynn suggests: "Wow, it looks like you've done a lot of research on this. I know you've got some strong ideas about this. Let me tell you how I see it and see what you think." Praising what they're already doing right, like getting regular sleep and exercise, also helps build rapport.
• Critique the information, not the source. Focus on the treatment that the resource is offering versus the one you understand as effective. Don't offer your opinion on the source unless asked. Even then, tread lightly. You might say: "I'm concerned that the person who might guide you in doing this is not well-trained. I don't know about their credentials; they don't make sense to me."
• Couch skepticism in humility. For example: "You know, I've read a lot about this problem, and I have not come across this explanation. I appreciate you telling me about it. It doesn't really make sense to me. Let me tell you how I think about it and then let's compare what you've read with what I've read."
• Steer them to credible online sources. Dr. Wynn suggests MedlinePlus.gov as a curated source for patients to do their own trustworthy medical research.

Engage minds: Now HEAR this

Resist the urge to correct patients, says Dr. Minson, which is a surefire way to end any conversation or hope of collaboration fast. "It's dangerous to get into persuasion land, where what you immediately want to do is change their mind," she says. "The worst-case scenario is when you fail to persuade and the patient feels like they can't talk to you anymore. Burning that bridge is really the biggest risk."

For confrontational interactions, Dr. Minson's research finds a technique called "conversational receptiveness" helps engage people with whom we disagree. The acronym HEAR describes the framework:

• H stands for hedging. In medicine, there's an exception for every rule-something social media is good at exploiting. Hedging helps address that. For example, instead of saying COVID-19 vaccines are safe and effective, you might say most physicians tend to believe that COVID-19 vaccines are largely safe and effective. "The point is still the same. But I make a little bit of space for your perspective," says Dr. Minson.
• E stands for empathizing agreement. You don't have to fake agreement with things on which you don't agree. Instead, find areas of common ground. For example, agreeing that you both want the patient and their family to be safe and healthy.
• A stands for acknowledgement. This step is one most physicians execute badly, especially when they're in a hurry, says Dr. Minson. "What people often do is something like, 'I hear that you've had a bad experience, but here's a reason why you should do this anyway.' That doesn't demonstrate that you really heard the person," says Dr. Minson. Acknowledgement reflects back what the patient tells you. For example: "I understand that a couple years ago, you had a vaccine that you thought gave you these side effects. You are really uncomfortable with the idea of getting vaccinated again because you had this experience."
• R stands for reframing the positive. Infuse your clinical advice with positive emotion and tone. Avoid contradictory or negative terms, such as no, can't, won't, or don't. For example, getting vaccinated helps prevent certain illnesses and make them less severe if you do get them. Not, if you don't get vaccinated you may get sick, hospitalized, or die.

"The key idea is that you're using language to communicate to your counterpart that you are truly engaged with their perspective," says Dr. Minson. "In the domain of COVID-19 vaccines, we found that following that framework does, in fact, make people trust you more, and does make them want to come back for your opinions on other topics again."

Embrace digital solutions

Speaking of credible sources, physicians may lament social media's hold on America's psyche. But social media can and should serve as a tool to disseminate legitimate health information. Some 65% of physicians already use some form of social media for professional purposes, according to a 2022 study published in The American Journal of Medicine.

To help support physicians' online presence, in July, the WSMA broadened its Your Care Is at Our Core public awareness campaign to include effective social media and public awareness health messaging. The goal is to help patients navigate health care information and bolster the evidence- based decision-making at the heart of the physician-patient relationship.

"It is information that you can use directly to improve your quality of outreach," says WSMA President John Bramhall, MD, PhD. "It's information to help restore and maintain the confidence that people have when they go to see a doctor."

Make a human connection

While physicians' default mode is to present data and let patients make their own decisions, Dr. Minon's research also finds people view stories as being more trustworthy than evidence or data. Of course, personal stories are a large part of what draws people to social media influencers.

"To the extent that your goal is to get them to take a specific action, it's helpful to mix the science with personal experience," says Dr. Minson. That could include a personal or patient anecdote, such as your own bout with COVID-19, or a heart attack patient who had refused taking blood pressure medication and had another heart attack.

"It doesn't necessarily need to be scary, but it's helpful if it's a little bit vulnerable. Those stories tend to be more vivid than the data," says Dr. Minson. "As much as we want to rely on data, that's just not how humans are wired."

Redefine your end goal: replace correction with connection

Even with the best tips, one conversation is unlikely to change anyone's beliefs. Instead, focus on building a bridge to the next conversation and the long-term patient-physician relationship, say Dr. Minson and Dr. Wynn.

When you replace correction with connection, patients are more likely to come back. "Whatever it is you're talking about right now is one medical decision in a lifetime of medical decisions," says Dr. Minson. "The goal is, will this person come back and talk to me again? Not, can I make them do this specific action right now, or change a particular negative behavior?"

Building that human connection first can help steer patients through all the social media noise and nonsense, says Dr. Wynn. "Even the most troublesome patients offer us an opportunity to fulfill the role that is most important to us, the role of being a healer. Because of the interaction, because of the relationship you develop, that person's suffering stops … It's the privilege of being a doctor."

Rita Colorito is a freelance writer specializing in health care.

This article was featured in the September/October 2025 issue of WSMA Reports, WSMA's print magazine.